2505. Using an Electronic Medical Record Alert to Screen Inpatient Encounters for People with Hepatitis C

Abstract Background Despite the availability of effective therapy, rates of linkage and uptake of hepatitis C virus (HCV) treatment remain suboptimal. People with HCV are hospitalized at a rate 3.7 times that of the general population, presenting an opportunity for linkage to care during inpatient admissions. We designed two novel electronic medical record (EMR) alerts to identify patients with HCV in two hospitals, and report on the alerts’ test-performance characteristics. Methods We developed two distinct EMR alerts and ran them silently on all adult hospitalizations at two academic medical centers in Baltimore, MD. Based on laboratory data, and diagnosis codes (Figure 1); the first alert identified all people ever infected with HCV (ever-alert); and, the second, only people with active HCV viremia (active-alert). We evaluated each alert’s positive predictive value (PPV) by manually reviewing all charts alerted during the study period. We evaluated alert sensitivity by reviewing a sample of consecutive hospital encounters during the same period to determine if they were alerted. Results From 6/29/2022-8/9/2022, the alerts examined 7,519 adult hospital encounters. The ever-alert was triggered for 569 encounters; 563 of 569 were truly ever-infected (PPV 98.9% [95% CI 98.1%, 99.8%]), and 202 of 569 were actively-infected (PPV 35.5% [31.6%, 39.4%]), corresponding to an active infection prevalence of 202/7,519 (2.7%). The active-alert was triggered for 267 encounters; 188 of 267 were actively-infected (PPV 70.4% [65.0%-75.8%]), corresponding to a 2.5% prevalence of active infection. The consecutive chart review examined 1157 patients, 122 (10.5%) of whom were ever-infected, including 44 (3.8%) actively-infected. The ever-alert identified 106/122 (sensitivity 86.9% [80.9%, 92.9%]) and the active-alert identified 37/44 (sensitivity 84.1% [73.3%, 94.9%]) of these respectively (Table 1). Conclusion An alert designed to identify only active infection has a comparable sensitivity (84.1% vs 86.9%) but significantly higher PPV (70.4% vs. 35.5%) for active infection than an alert designed to capture any infection (active or ever). These results support the use of an EMR alert for an HCV outreach program to link patients to care. Disclosures Oluwaseun Falade-Nwulia, MBBS ,MPH, Abbvie Inc: Grant/Research Support|Gilead Sciences: Advisor/Consultant Kelly Gebo, MD, MPH, Pfizer: Advisor/Consultant|Spark HealthCare: Advisor/Consultant

2505.Using an Electronic Medical Record Alert to Screen Inpatient Encounters for People with Hepatitis C Patrick Pryal, MS3 1 ; Walid El-Nahal, MD 2 ; Thomas Grader-Beck, MD PhD 1 ; Grant Wilson, BS 1 ; Brad Beatson, MS4 1 ; Oluwaseun Falade-Nwulia, MBBS, MPH 3 ; Kelly Gebo, MD, MPH 4 ; Stephen Berry, MD PhD 1 ; 1 Johns Hopkins University School of Medicine, Baltimore, Maryland; 2 Johns Hopkins School of Medicine, Baltimore, Maryland; 3 Johns Hopkins University, Baltimore, MD; 4 Johns Hopkins, Baltimore, MD Session: 239.Hepatitis Saturday, October 14, 2023: 12:15 PM Background.Despite the availability of effective therapy, rates of linkage and uptake of hepatitis C virus (HCV) treatment remain suboptimal.People with HCV are hospitalized at a rate 3.7 times that of the general population, presenting an opportunity for linkage to care during inpatient admissions.We designed two novel electronic medical record (EMR) alerts to identify patients with HCV in two hospitals, and report on the alerts' test-performance characteristics.
Methods.We developed two distinct EMR alerts and ran them silently on all adult hospitalizations at two academic medical centers in Baltimore, MD.Based on laboratory data, and diagnosis codes (Figure 1); the first alert identified all people ever infected with HCV (ever-alert); and, the second, only people with active HCV viremia (active-alert).We evaluated each alert's positive predictive value (PPV) by manually reviewing all charts alerted during the study period.We evaluated alert sensitivity by reviewing a sample of consecutive hospital encounters during the same period to determine if they were alerted.
Conclusion.An alert designed to identify only active infection has a comparable sensitivity (84.1% vs 86.9%) but significantly higher PPV (70.4% vs. 35.5%)for active infection than an alert designed to capture any infection (active or ever).These results support the use of an EMR alert for an HCV outreach program to link patients to care.
Disclosures.Oluwaseun Falade-Nwulia, MBBS ,MPH, Abbvie Inc: Grant/ Research Support|Gilead Sciences: Advisor/Consultant Kelly Gebo, MD, MPH, Pfizer: Advisor/Consultant|Spark HealthCare: Advisor/Consultant 1 North Jersey Community Research Inititiave (NJCRI), Denville, New Jersey 2 Saint Michael's Medical Center, Newark, NJ, USA, Newark, New Jersey 3 NJCRI, Newark, New Jersey st 2020 and Sept 31 st 2022 at North Jersey Community Research Initiative (NJCRI), dividing patients in group 1: patients required by their insurance to fill up prescriptions through Managed Medicaid's Preferred Specialty Pharmacies (PSP), which are corporate mail-order pharmacies and group 2: those who could fill their prescriptions with a local contracted community based pharmacy.We had two primary endpoints comparing those 2 groups: 1-Difference in wait time from the provider's visit to starting therapy; 2-Difference in percentage of those completing therapy.S1086 • OFID 2023:10 (Suppl 2) • Poster Abstracts

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Medscape Education, TARRYTOWN, New York • Utilize key differences between available hepatitis B vaccines to counsel and appropriately vaccinate patients (67%) • Apply the Advisory Committee on Immunization Practices (ACIP) recommendations for hepatitis B vaccination (66%) • Implement the latest universal vaccination recommendations for the hepatitis B vaccine (59%) • Identifying patients who are candidates for hepatitis B vaccination (59%) • Patient misinformation, inaccurate expectations, and vaccine hesitancy • Multiple doses, decreased adherence, and patients being lost to follow up • Understanding the indications for various hepatitis B vaccines • Time restraints of staff and training needs Abstract citation ID: ofad500.2123